Do not resuscitate

On the refrigerator is some notice from Hospice informing caretakers to attempt no resuscitation should she stop breathing.

Drove up to the house, where my father sits holding the hand of my wheelchair confined mother. Her nails are painted a garish pink, looking grotesque on her thin and mottled hands. My hands.
I see her greet my aunt with confusion. She sees me, she smiles. Absolute recognition. She flings her arms out to hug me. "Did you bring me lunch"? she asks. Confusion. She has no appetite.

The radiation treatment caused hair loss, so she shaved her head rather than suffer the trauma of waking to a hair-caked pillow.

A Buddhist woman asks me, "does she know you love her?" while I'm in a hospital hundreds of miles away.
And, do you feel so unworthy of his love?

For the first three months I was away, she called me weekly. Beyond, she wondered where I was, and why I wasn't home.

She lies on her bed in the livingroom, and says tangentially, "You're a brat." Then she smiles. And says she loves me.

who are those people? ...
aren't my flowers so pretty?
...
how could you ...
she's my best friend.
how could you? she's my daughter. (she says to my father, and we inform her his never, would never happen.)
I can't go, I have to take care of my little girls.
All this fire. fire. no no why no no no
I love you.
I love you. I love you.

Her last spoken words were, "love you, love you all. come to you with thankfullness as I depart from this world."

She was as vain as a girl with recently formed breasts when she started losing weight.

She had stage IV melanoma. Eleven years before her death, she had many surgeries and chemotherapy for the melanoma tumor on her arm. Success. She had said that she needed ten more years to finish raising her children. She got 11 years.

I keep forgetting that she's dead, whether that's because I think she's still alive or that she never existed.
Soon after her death I acquired the Christian perversion of guilt. I do not understand.

Jason Altom was perhaps the brightest
of them all; his fellows and friends in Harvard's
prestigious chemistry department envied him for the advances he made
in synthesizing complex organic molecules. His
research method was so rigorous and meticulous that some would consider
him the prodigal son of his research advisor, Elias J. Corey, the 1990
Nobel laureate, and by many considered the
leading chemist of our times.

Jason was as ambitious as talented. At the start of his Ph.D.
program, Corey offered him three projects, with varying degrees of
difficulty. The one Jason had his eyes on was the hardest of them all;
the one Corey group sometimes jokingly referred to as the
"Holy Grail of chemistry".

What Jason set out to do was to create a complex organic molecule by
a sequence of directed chemical reactions. It is a
construction kit on molecular scale: take the backbone of an organic
molecule, extend it by adding another molecule. Remove
sidegroups of atoms from the backbone. Add other specific
sidegroups to the backbone. Close one part of the chain to form a ring.
Choosing the right reactants, ligands, chemical
reactions,reactants, and their sequence is a mindbreaking puzzle: one
reaction can make or break a chemical bond on a desired location, but
will also do so where this is not desired. Some reaction steps look easy
on paper, but can only be achieved by making a large detour: add more
complex groups to the molecule and remove parts of these with a series
of reactions. As the molecule grows in complexity, it becomes
progressively more difficult to modify it without destroying other parts
of the structure. It is like running a maze with an infinite number of
dead ends. Some roads seem to head for the exit, only to end in a
rock-solid wall, a few months down the road.

Initially, Jason seemed to be making good progress. He
synthesized the most difficult part of the molecule first,
and then the other half. All what was left was to link the two parts
together. Corey claims that he suggested Jason to wrap things up: write the thesis and
earn the doctorate. The total synthesis, or linking of the two
parts could be done by a postdoctoral fellow. But Jason was
ambitious and convinced his advisor that he wanted to achieve
the entire synthesis himself. He believed that he should meet this goal
to make a chance at a top academic position.

The total synthesis proved to be harder than he thought, and
the project was going from one disappointment to the other. Halfway
through his sixth year at Harvard, he thought he had finally solved the
problem... but upon further analysis he was back to square one, and it
seemed that coupling these two specific molecules to form the larger
complex simply could not be achieved. Several years of hard work, often
70 hours per week, had resulted in a project that was essentially back
to its initial problem statement.

One day in August 1998, Jason retreated to his room to work on a semi-annual
progress report for his advisor. This is where his roommates found the
body of the twenty six year old graduate student. A note on his bed read:

Jason's suicide was planned as methodical as he conducted his
research. One of his roommates explained later: "I think he was
worried, in his meticulous way, that someone might try to give him mouth-to-mouth resuscitation"1 [and by doing so, swallowing some of the poisonous cyanide themselves].

The warning note wasn't the only one Jason left. In three letters ---
one to his parents, one to the chairman of the chemistry department, and
one to his advisor--- Jason explained his motives for committing
suicide. To the department chair he wrote:

"This event could have been avoided.
Professors here have too much power over the lives of their
grad students". [Having a committee of three professors involved
in the evaluation of graduate student's progress would] "provide
protection for graduate students from abusive research advisers. If I
had such a committee now I know things would be
different."

Suicide is not an uncommon occurrence amongst graduate students. In
fact, suicide rates among graduate students are significantly higher
than among the general public in a similar age
group2. Jason Altom was the eighth victim
at Harvard since 1980. Three of these suicides were students working for
Elias J. Corey. What made this suicide stand out from the others were
the letters that Jason left behind, blaming his death on the abusive
behavior of his research advisor.

Having been through the Ph.D.
experience, I can attest to the feelings of isolation, despair and
pressure involved with graduate research. The road to obtaining a
doctorate is uncertain, and long: five, six years seems to be the norm,
but some people are stuck for ten years or more. All this time is
invested in one gargantuan project. The goal is sometimes unclear, and
the objectives are often changing, or pushed ahead. However, the
investment of so much blood, sweat, and tears means that the doctoral
candidate gains a strong identification with his research topic. The
thesis becomes a focal point that blurs out anything surrounding it, and
it is easy to lose an objective overview: well-meant critique from
outsiders is brushed away, or met with hostility. Inevitably, problems
arise with the research, or even worse, a total failure of the project.
Overcoming the fears and feelings invoked by this are the most difficult
task of obtaining the doctorate. The isolation can break relationships,
friendships, the will to enjoy life, or even the will to continue
living. I have witnessed them.

Much has been said about the role of Jason's research advisor in the
matter. Students in Harvard's chemistry department describe him as
evil. His own students revered him, but also feared him.
Typically, a research advisor has a boundless control over the destiny
of his Ph.D. candidates. Ultimately, its his signature alone that
determines whether the dissertation is accepted or rejected. But his
power goes beyond awarding the doctorate: a positive letter of
recommendation is often the difference between obtaining a prestigious
academic or industrial career, or settling for something less
ambitious.

No doubt Corey was aware of his reputation as "evil advisor", but it
seems as if he did little to dispel it. It encouraged his group to push
their boundaries. Unfortunately, some of them pushed it too
far. But it isn't fair to put all the blame on the research
advisor: although the university and the research groups in particular
facilitate or promote the stressful environment, the ultimate
driving force comes from within the students. It is their ambition,
career goals, and drive for perfection that drives them to the edge.
Research advisors don't have to be actively involved in whipping
up the young professionals. They are perfectly capable of creating their
own ghosts.

However, this doesn't mean that active forms of academic
abuse don't exist. Some research advisors act more like slave drivers than as mentors involved in an academic learning
experience: the degree is only a stick and carrot. It becomes a
decade-long version of Survivor, where they put students on similar
research topics, and only the fastest and strongest gets the prize.
They wind you up, put you down, and watch you go.

The underlying reason for the academic rat-race goes beyond the
power-position of (tenured) research advisors. It is academia
itself that puts too much emphasis on goal-achievement rather than the
approach. Graduate Students are evaluated on the outcome of their
project, rather than the method in which they conducted the research.
The university needs to be a place where students learn to conduct
science; to properly learn the scientific method. The end result of
the project should be of less importance.

To anyone in Corey's group, it was clear that Jason Altom was a
top-class researcher. He had demonstrated that he could conduct science
at the highest level. Yet, he believed that all his work would be
discredited without reaching the final goal, as if the entire learning
experience counted for nothing. The goal-oriented approach is deeply
ingrained in academia. In fact, my advisor made it quite clear that a
"negative dissertation" would be "very difficult to sell" to my
thesis committee. It is not likely that this attitude is going to change
any time soon. Even funding agencies such as the NSF operate on a goal-oriented basis, because that is how
they justify their spending. It should come to no surprise that much of
the reported science in the literature is flawed, bending of the truth,
or sometimes even a blatant lie. The scientific truth hurts when you are
trying to receive your doctorate, or the next big research grant.

One month after Jason Altom's tragic suicide,
Harvard instituted several changes to their graduate program to reduce
the singular control of the academic advisors over their students. Under
the new regulations, a committee of three professors, including the
research advisor evaluates the research and career goals of the student
on a yearly basis. While it seems unlikely that life-long colleagues
will act strongly against abusive behavior of their peers, and students
will still fear the long-term consequences of speaking up, this system
is a first step in the right direction. Jason Altom's tragic and
unnecessary death has opened up a dialogue on the issues of academic
abuse. It is the only positive outcome of his tragedy.